Proposal to Furnish

PROPOSAL TO FURNISH

TO: BOARD OF SUPERVISORS, STONE COUNTY, MISSISSIPPI

C/O GERALD BOND, CHANCERY CLERK

STONE COUNTY COURTHOUSE

323 EAST CAVERS AVE., WIGGINS, MS 39577

PH: 601-928-5266

GENTLEMEN:

The undersigned hereby offer(s) to furnish unto Stone County, Mississippi, and/or

STONE COUNTY BOARD OF SUPERVISORS, the following supplies, personal property and/or services at the following price(s), to wit:

ITEM: HOT MIX ASPHALT / PER TON (Award Will Run Through December 31, 2016.) Stone County Board Of Supervisors Will Pick Up & Haul Asphalt To The Designated Locations.

PRICE: $______

All prices include any pre-delivery and/or set-up charges, title and inspection fees, and preparation services, (where applicable). This offer is in response to your “Notice To Bidders” dated the 21ST day of March, 2016, and the specifications therein referred to, both of which are incorporated in and made part of this offer. We fully understand said Notice and specifications and the requirements thereof. The quoted price does not exceed the price to the general public for items of the quality and quantity nor does it exceed the price permitted by law.

We realize that no responsibility will attach to the County or its employees for inadvertent pre-mature opening of any bid and that we are responsible for submitting our proposal in a

sealed envelope clearly marked in the lower left corner “Bid For: HOT MIX ASPHALT / PER TON” 10:00 AM / MAY 2, 2016 and which sealed envelope also must bear our Certificate of Responsibility Number (if applicable). Bids not so clearly marked on the outside of the envelope may be rejected.

This bid may be withdrawn by actual delivery of written notice thereof unto the Stone County Chancery Clerk prior to the time and date designated for receipt of bids, but this bid may not thereafter be withdrawn for 30 days.

(OVER / SIGNATURE PAGE)

NAME OF VENDOR / FIRM:______

SIGNED BY (PRINT NAME):______

SIGNATURE:______

TITLE:______

ADDRESS (City / State / Zip Code):______

______

TELEPHONE:______

CERTIFICATE OF RESPONSIBILITY NUMBER (IF APPLICABLE)

#______

DATE:______

{RE: PREPOSAL TO FURNISH / HOT MIX ASPHALT – PER TON}

Bid Opening: May 2, 2016 / 10:00 AM

Return To

STONE COUNTY BOARD OF SUPERVISORS

PURCHASING DEPARTMENT

P. O. DRAWER 7 / 323 EAST CAVERS AVENUE

WIGGINS, MS 39577